THE TAMPA BAY CHAPTER
CHAPTER APPLICATION
Remit payment to:
ACFE Tampa Bay Chapter
P.O. Box 175
Tampa, FL 33601
FISCAL YEAR ENDING JULY 31, 2010
Association of Certified
Fraud Examiners
Tampa Bay Chapter
FEI #59-3151735
Name:
Business Phone:
Designations:
Home Phone:
CFE Number:
Business Fax:
Required for Members & Associates
Employer:
Job Title:
Address:
City:
State:
Zip:
E-mail Address:
Required for Newsletter Distribution
Membership Selection (check one):
Chapter Member - $25
Must be a Certified Fraud Examiner and a Member of the ACFE.
Chapter Members are eligible to vote and hold office in the Chapter.
Chapter Associate - $30
Must be an Associate Member of the ACFE. Chapter Associates are
eligible to vote and hold office (other than President) in the Chapter.
Chapter Affiliate - $30
Not a Certified Fraud Examiner or an Associate of the ACFE. Chapter
Affiliates are not eligible to vote or hold office in the Chapter.
Student - $25
Full-time student currently enrolled in degree programs. Student Members
may not vote or hold office in the Chapter.
Organization Membership
A 20% discount is available when at least five (5) professionals join from
the same organization.
Scholarship Donation
$10.00 donation to the Chapter's scholarship fund.
Note: Chapter dues do not include the annual dues for the ACFE. Call (800) 245-3321 to join the Association.
Signature:
Date:
Questions about your membership? Call Gary S. Chapman, Membership Chairperson, at (813) 274-7163.
Note: Membership dues may be deductible as a business expense, not as a charitable contribution.
THANK YOU FOR YOUR SUPPORT.